[Music] welcome everybody to columbia enterprise college government schooling i am charles bouyon and i am right here in the present day with carrie chan and stan kuknowski for the brand new alternatives in digital well being webinar earlier than i introduce carrie and stan i’ll simply go over some temporary logistics which can seem in your display a recording will probably be out there after the webinar we additionally encourage you to tweet in regards to the webinar utilizing the hashtag cbs execute and at last we would like you we need to hear from you through the webinar so please kind your questions within the q a field and we are going to reply as a lot as those who we will within the final 10 minutes of the webinar however now it’s my pleasure to introduce you to our visitor in the present day carrie chan is an affiliate professor of enterprise within the determination danger and operations division at columbia enterprise college chan’s analysis combines empirical and stochastic modeling to develop evidence-based approaches to enhance affected person move by means of hospitals she has labored with clinicians and directors in quite a few hospital methods together with northern california kaiser permanente the big apple presbyterian and montefiore medical heart stan kurknovsky is the chair of the digital well being group hit lab and an oxford educated researcher who has taught over 5000 college students from columbia college iit delhi and quinnipiac school his educating and analysis over the previous 25 years contains educating graduate stage and government college students on 4 continents and conducting intensive research on the efficacy and diffusion of digital well being together with digital information seize epro wearables and predictive algorithms i will be again within the final 10 minutes of the webinar and now i am going to flip it over to you carrie and stan thanks charles and thanks everybody from all over the world for becoming a member of us right here in the present day and uh admire your time uh we’ll take this subsequent hour to stroll you thru a couple of issues uh initially we need to speak to you in regards to the definition of digital well being this rising discipline that is quickly altering healthcare you already know in a method that is actually revolutionary we do not often like to make use of that time period however revolutions often signify fast change inside a 12 months or much less and that is one thing that we’re seeing now in healthcare with the virtualization of care on account of the coveid pandemic we additionally need to speak somewhat bit about a number of the insights and alternatives in digital well being after which lastly we need to stroll by means of a number of the examples of how columbia enterprise college government schooling is offering steerage and schooling and certifications throughout 4 totally different particular areas and others to observe sooner or later for executives all over the world we’ll clearly be taking questions uh all through so please be happy to make use of the chat bar to ask questions and we’ll be taking questions on the finish as charles talked about first let’s speak in regards to the definition of digital healthcare and it truly is a discipline that is been round for a few years relationship again to essentially the the start of computer systems and laptop methods and hospitals and insurance coverage corporations within the Fifties you may see references to a few of these applied sciences in books like severed belief by dr lundberg when he talked about in that e book how he was coaching as a doctor uh in the big apple and he was taking digital well being document lessons with ibm in armonk and so digital well being as a assemble is absolutely this grouping of bioinformatics which incorporates all the info from the human physique genetics metabolomics uh genomics uh proteomics exosomics and so on so it may very well be from saliva or blood or tissue or hair any of that became information after which whenever you have a look at the the info across the human physique whether or not it’s digital well being information telemedicine it may very well be your wearable that you simply’re sporting it may very well be an app that you simply’re utilizing it may very well be issues like advertising information it may very well be iot from units that you simply’re utilizing definitely alexa and google and siri are actually thought-about a part of the digital well being ecosystem and algorithms and so on so once we begin shifting into this digital healthcare world we speak about taking bioinformatics and mixing it with biomedical informatics after which creating this assemble from the 2012 e book the artistic destruction of drugs of the digital human and digital drugs and on a person foundation whenever you take all this information and also you combination it how will you change the way in which sufferers are handled throughout the healthcare system after which whenever you combination all of these sufferers into populations how will you change issues like inhabitants well being administration uh and how will you start to have extra vital views and insights on issues like pandemics and like with the ability to analyze information round and amongst massive human populations to then change the interventions and modify the interventions which can be getting used to enhance human well being not simply on a person foundation however on a worldwide and inhabitants foundation as nicely and once we have a look at a number of the classes which can be evolving on this new rising discipline known as digital well being there are 12 main classes and we cannot undergo every one in every of these proper now but it surely’s necessary to grasp to acknowledge that these classes themselves are quickly evolving and the pandemic has taken a extremely an effort and a motion that was shifting rapidly to start with and accelerated it to a degree the place even of us who’ve been doing analysis and educating and training on this discipline over the past 30 years had have by no means seen i imply it actually is an awfully accelerated motion that we’re seeing in areas like healthcare ecommerce and healthcare provide chain and apps folks utilizing their apps to grasp what what’s the latest data round covid round asymptomatic coveted therapies prevention public well being measures are actually being taken in digital well being areas that we have by no means seen earlier than as nicely broad public well being campaigns and genetics are being utilized in methods we have by no means seen to kind the totally different strains of covid telemedicine has grown exponentially right here at columbia medical heart and the big apple presbyterian hospital the usage of telemedicine has grown from roughly a thousand visits per week to upwards of 30 to 40 to 50 000 visits per week and these are the kinds of issues that when folks speak in regards to the fast virtualization of care actually what they’re speaking about are plenty of the kinds of digital well being applied sciences that you simply’re seeing in entrance of you on the display and simply to present you some footage and to form of visualize it for you somewhat bit additional listed below are a number of the applied sciences which have grown considerably simply within the final six months though they have been already doing fairly nicely earlier than then however applied sciences like what you see with amazon and the halo that was simply launched this week publicly clearly apple watch um there is a main examine being accomplished proper now about with the ability to use the apple watch as a kobit diagnostic gadget a number of the most diffusive digital well being applied sciences that we have seen are issues like resmed now actually providing prime quality prime quality scientific grade sleep service on the bedside and so we’re seeing plenty of digital well being applied sciences within the dwelling on the human physique but additionally within the provide chain issues like data mediaries medic with the ability to provide chain and incorporate the the instruments round remedy adherence and supply throughout the provide chain 23andme is a superb instance of how digital well being has made its method into the patron mindset the place folks are actually utilizing 23andme to choose up genomic assays of themselves to grasp their origins to grasp some illness units uh and the identical factor with ancestry.com utilizing genetics as a method of understanding their healthcare higher one drop which is known as a very comparable mannequin to shaving membership for males however for diabetics based in the big apple metropolis and an organization now that has over one million engaged customers a month utilizing their platform to higher perceive what is going on on with their diabetes managing their weight loss program a colourful group a really vibrant app and a glucometer that is included in a annual subscription so these types of digital applied sciences are unimaginable and the investments we have seen over the past six months in january by means of june the quantity of funding in digital well being really grew by 20 through the pandemic throughout this recession uh or nearest recession at a time when many individuals are usually not investing uh investments in digital well being grew 20 in the usa and as you noticed two weeks in the past lavongo was bought by teledoc for 18.5 billion {dollars} once more indicating that these two publicly traded corporations merging are solely an indication of issues to return round this fast motion towards digital well being care how has columbia enterprise college government schooling responded we are actually providing a digital well being collection this fall throughout digital well being technique well being information science good investing in digital well being and managing digital therapeutic approvals which have now turn into extra necessary than ever given the covid pandemic these packages can be found on the web site on that web page and you too can contact me because the one of many of us collaborating in directing these packages by means of linkedin and we would be completely happy to ship you extra data as nicely by means of the web site that being mentioned we would like to present you somewhat little bit of a taste and a few examples of what you’d be studying in these packages becoming a member of me right here is professor carrie chan who will stroll you thru somewhat little bit of what she’s been doing in analysis in digital well being as nicely kerry nice thanks stan uh and thanks for all of you uh being right here as stan mentioned he gave an excellent overview of a number of the tendencies in digital well being and what i might love to do is give a teaser of only one particular instance of what’s potential um and as i stroll by means of this i simply need to remind all of you that as questions come up please be happy to make use of the q a field i’ll reserve a while on the finish to undergo as many um as potential so what i might love to do is speak about the usage of predictive analytics and the way this may really be used to enhance affected person move in hospitals and particularly the emergency division so subsequent slide please so that is the problem with crowding at emergency departments has been round for a lot of a few years uh it is turn into much more noticeable now through the explicit pandemic and this may create main challenges in offering prime quality care to sufferers so in a survey of many various hospitals of various differing kinds nearly all of time folks imagine that the emergency division is at and even over capability so crowding is definitely an enormous difficulty so what we need to do is attempt to see if there are methods to handle it subsequent slide so one technique that’s utilized in emergency departments is what’s known as diversion and that i need to use the time period diversion really within the broadest sense um so most individuals consider diversion as ambulance diversion if the emergency room is just too full they could really reroute ambulances to different hospitals as a result of they know they will accommodate incoming sufferers however i additionally need to seek advice from this as various methods corresponding to encouraging sufferers who’re of decrease severity that maybe their wants may very well be met by going to their major care doctor or an pressing care facility as an alternative um and even telling major care physicians that the emergency division is at the moment very full and if their affected person is looking them to see the place they need to see care the pcp might really refer them to their outpatient services or an pressing care facility and so on this method this might cut back the quantity of admissions coming to the the emergency room now this may be useful um as a result of that would cut back wait occasions now most of these methods are at the moment solely used as soon as the unit turns into very very full so as soon as um the emergency room has many many sufferers and it is difficult to to deal with all of them however one factor that we do discover from a well being information science standpoint is that really arrival to the emergency division are very predictable uh so we will have a look at elements corresponding to day week so there’s very clear seasonal patterns mondays versus sundays are very totally different holidays you see um substantial patterns climate patterns so you already know blizzards versus um warmth waves additionally uh present some predictability of what arrivals are going to be so what we’re holding should you can click on stan thanks uh is to attempt to see if we will enhance the wait occasions within the emergency room by leveraging these predictions of the longer term so as an alternative of ready for issues to get crowded earlier than performing we might really see into the longer term have predictions of when the unit might get crowded and act in a proactive method go to the following slide we will attempt to perceive intuitively what may very well be occurring so what causes lengthy delays within the emergency room nicely it is actually when you will have a burst of arrivals coming as an alternative of individuals leaving so if we have a look at the blue dots as arrivals of sufferers and the pink x’s as sufferers leaving when you will have a stream of many sufferers arriving and all needing service the primary affected person creates delays for all of the sufferers that arrive after it and so within the conventional reactive method what occurs is that the models of their emergency division will anticipate the build-up of sufferers those who preliminary affected person that is inflicting delay to see that this burst occurred what we will do as an alternative is use predictions to say we all know that this burst is coming so as an alternative of ready for the top of it the place the entire sufferers have already created delays for one another we will really act at first and so we will deal with the identical variety of sufferers however probably cut back the general delay so if we go to the following slide we will attempt to see how this future data will assist us handle these first so the following slide um what we did was we used this instinct and we created a coverage that compares this threshold coverage of ready till there’s too many sufferers within the emergency room earlier than reacting versus this proactive coverage that makes use of the longer term data and so we created a simulation of a 20-bed emergency division and we used the predictive data to find out once we ought to make these selections so after all we won’t see totally into the longer term the shorter the horizon the extra correct our predictions are going to be so we’re simply taking a look at a 24-hour window of future data we’re assuming that there is no details about the service occasions and as i highlighted earlier we will see right here within the sample of arrivals um from a that is these are actual um arrival charges from a emergency room in israel there are very distinct temporal patterns so we all know that um between you already know 12 sorry 10 a.m to three p.m there’s form of a peak in our rivals after which in the midst of the evening and early morning there is a form of a lull so we leverage this data to attempt to perceive when ought to we go on diversion if we go to the following slide um what we’ll have a look at now’s the the end result and naturally we won’t predict the longer term completely so what we’ll see is that we now have these predictions after which there’s some noise time period and you may consider this noise time period if our predictive mannequin relies on a regression evaluation this noise time period captures form of the uh match of that regression mannequin and um so if there is no noise in order that i am parametrizing this by a price q um i can really predict the longer term completely after all we would all love to have the ability to do this however that is unrealistic so within the uh excessive state of affairs the place q is the same as 100 we even have very dangerous predictions um however what this desk reveals us is in every column we now have the established order so that is the usual strategy that’s reacting to congestion of what the wait time could be and so it is somewhat over 4 hours versus what we might will we leveraged these predictions of when the arrivals are going to return and so we’re being extra strategic about which affected person is inflicting you already know delays for all the opposite sufferers and so you may see that we’re in a position to cut back the ready time by fairly a bit by leveraging this data now definitely because the noise and the accuracy of the prediction degrades our the quantity of enchancment we will get additionally degrades however we nonetheless see you already know between a 7 to fifteen discount in ready occasions by leveraging this future data by utilizing this predictive analytics uh and so this may have particularly in an emergency division the place there are particular circumstances or well timed entry to care can imply life or loss of life these variations can have a extremely massive affect so we go to the following slide what i might i might like to simply summarize and once more that is only a a morsel to present you a way of what may very well be potential with utilizing most of these instruments um predictive fashions and periodic predictive analytics is definitely rising throughout the healthcare house and here is simply an instance of how they can be utilized to enhance operational efficiency the quantity of information that’s turning into out there uh throughout the healthcare house each by way of the advance and standardization of digital medical information methods but additionally by means of lots of the units that stan confirmed earlier in his um dialogue it actually presents an excellent alternative to grasp how that information can be utilized to really enhance high quality of care and this may have a big effect um on on outcomes so with that i might wish to thanks for your entire time i’ll flip the baton over to charles who will handle the q and a session and we definitely welcome questions and hope that we are going to see a few of you uh in over the following couple of weeks on a number of the actual ed packages thanks thanks carrie and stan that is nice so now we now have some nice questions which got here through the presentation uh initially we now have a query from what are the important thing business shifts throughout covet 19 and what applied sciences are getting traction i am going to begin with that after which perhaps stand if you wish to add some you may i feel one of many greatest factor with covid19 has been the expansion of telemedicine definitely so out of necessity each on the supplier aspect to scale back the variety of sufferers which can be coming to the clinics but additionally from sufferers concern of interacting with others there’s been an enormous shift to telemedicine and i feel that there have been business tendencies saying that telemedicine was rising pre-covered 19 however this was actually the push um to get us right into a regime the place you already know even because the pandemic form of regulates and the priority is decreased telemedicine is right here to remain and so i feel that that is a an enormous space um that is gonna to develop uh associated to that can also be on form of just like the wearables and gadget and so um you already know i do know inside the big apple metropolis the big apple metropolis well being and hospitals the general public well being care system right here we’re utilizing wearable displays and sending affected person dwelling with distant monitoring turing units to have the ability to monitor coveted sufferers um to see if there’s a deterioration and form of be extra proactive in regards to the care but additionally recognizing there’s a profit to having sufferers have the ability to go dwelling and never having to remain within the hospital yeah simply to essentially i feel complement that somewhat bit the the sum of money going into well being care proper now whether or not it is the the parents the wealthiest 1 billion or the poorest 1 billion uh is unprecedented and it is actually like a wartime motion so each single uh group from authorities company to an instructional medical system to a well being plan to a life science firm they’re fully re-engineering their processes as a result of they should discover ways to do every little thing remotely so whether or not it is a scientific trial or whether or not it is learn how to attain physicians for directivist directed doctor advertising or attain sufferers to really get them their both their scientific trial drugs or their most cancers drugs uh it is a it is a completely new provide chain and we’re seeing reinvention happen throughout the board and i feel that is why you are seeing a lot funding transfer into the healthcare system particularly round digital healthcare they’re simply completely rising uh their fashions and their re-engineering you may’t change a course of uh otherwise you you may’t simply add a expertise and anticipate to anticipate the method to stay the identical in order everyone seems to be altering their processes and including applied sciences they should now re-engineer the processes direct dramatically and it is it is inflicting this unimaginable shift throughout all of these paradigms and we i feel we also needs to add genomics and the flexibility for these genetic markers to be traced all over the world and the testing that is being accomplished is is really extraordinary uh one final thing is a regulatory atmosphere we now have by no means seen a regulatory atmosphere like this within the historical past of healthcare expedited use authorizations in the present day and actually since march have seen there have been extra expedited use authorizations in within the final six months than within the final 10 years we’re seeing a dramatic shift with the meals and drug administration and the way they’re approaching this and once more that is an enormous a part of the managing digital therapeutic approvals uh program that will probably be supplied in a while within the fall nice um thanks subsequent uh we now have a query from jawadi a query about carrie’s analysis is the worth to the sufferers restricted to saving and ready time or something past thanks for the the query so i feel you already know there’s two points you may consider from financial savings of ready time and that is a really clear metric that’s being always monitored definitely sufferers are going to be happier the standard of care there have been research that reveal weighting is related to poorer outcomes and so that may additionally enhance outcomes for sufferers by lowering weighting however let me flip this round and one other method to consider it’s from an operational standpoint and a monetary standpoint from the hospital is that you already know we’re in a position to for a similar quantity of workers obtain a greater high quality of service or high quality of care and so one other method to consider it’s you possibly can say if i keep the identical high quality i might probably really obtain that with decrease operational prices you might be able to obtain it with um or you already know fewer workers as an example um or you already know fewer beds for example so i feel that there are you already know for my work i actually focus first on the affected person outcomes and but it surely positively has impacts on the monetary backside line for a lot of of those methods then we have a query from max how rather more information do you suppose a few of these predictive analytics fashions want so as to quickly enhance operational efficiency in hospital and so on i am going to take that um so i feel um it relies upon i so i feel that there are locations inside hospitals there i suppose i wish to refer them as low-hanging fruit the place the info is there uh though you possibly can get higher information uh it there are nonetheless inefficiencies throughout the well being care system that taking that information um and using it could make huge enhancements there are estimates that say 30 p.c of healthcare prices are are waste and so there are definitely areas inside um hospitals as an example and likewise outpatient clinics that um there are huge enhancements that may be made with the present information that is to not say that there are different areas the place definitely information constancy is a problem and truly that is the place the chance and people settings are is absolutely making an attempt to grasp what’s the proper information to gather how will we facilitate that assortment of information and you already know getting again to stan’s feedback earlier like the sector of bioinformatics is absolutely about making an attempt to grasp what information is efficacious and learn how to acquire it and coalesce it in a unified method nice um then we have one from carla is that this scale of telehealth shifts comparable on world foundation in public methods or primarily in our privatized u.s healthcare system yeah that is an excellent query i feel we’re seeing this occurring globally the uh whether or not it is a public well being system or personal well being system the the necessity for telemedicine and the necessity for digital care platforms that kerry talked about earlier are important and as are the necessity for fast trials and new diagnostic units for the house whether or not it is self-administering blood attracts or with the ability to assist of us monitor their pulse ox remotely we’re seeing these in india as a lot as we’re in the usa so once more of many college students in india proper now and uh in the event that they’re recognized with covet they’re being given pulse ox units to take dwelling and to measure uh how their uh blood co2 ranges are doing and that is one thing that we’re seeing globally uh and i feel that that will even be a continued development so long as this pandemic is right here and i feel that one of many key issues in regards to the packages and the collection this fall is educating those who their methods now their funding theses managing their therapeutic approval processes or re-engineering their digital uh science packages it isn’t simply in regards to the the pandemic it is also post-covet as nicely and so it’s a world phenomenon it’s not uh merely a uh privatized healthcare system phenomenon nice uh and i feel we have uh time for only one fairly um final fast query sorry a query from uh arcana do your packages pertain to hospital care business or do additionally they embrace pharma life science context for reforstand yeah it’s for it’s actually for hospital executives by the way in which all of the packages have been cme authorised by the cme workplace at columbia medical heart so in case you are a doctor completely perceive that they’re cme authorised as an example digital well being technique has cme authorised for 28 credit um but it surely’s additionally for all times science executives we’ll have a number of the main executives from life science corporations uh and in addition to from amazon and google and apple and microsoft and so on so we now have a trove of uh mental horsepower from columbia enterprise college columbia college and practitioners all over the world and it’s for all industries life science hospitals well being plans definitely buyers and folks working in regulatory environments whether or not they’re educational medical heart investigators or others so it’s a these are these 4 packages are good packages for anybody working in healthcare life sciences in the present day thanks proper um we have come to the top uh thanks carrie and stan a lot on your time in the present day uh throughout this nice webinar and thanks everybody on your nice questions we are going to observe up quickly with the recording and we hope to see you quickly in one in every of our lessons all one of the best and have an excellent week goodbye